Studies Reveal COVID-19 Collateral Damage to Global Cardiovascular Services

Major studies have revealed “global collateral damage” caused by interruptions in cardiac service due to the COVID-19 pandemic.

Researchers warn that heart health problems “… will continue to occur unless mitigation strategies are implemented quickly.”

Individuals who have experienced an acute heart event, such as a heart attack or heart failure, during the two years starting December 2019, when medical systems around the world were under extreme pressure and people were afraid to become infected with COVID-19. I couldn’t leave or be hospitalized. To the hospital.

This study describes the “substantial global decline” in hospitalization for people suffering from cardiovascular disease.

As a result, more people are dying of heart disease at home or in the community.

On average, when people received medical assistance, there was an hour or more delay in arriving at the hospital or contacting emergency personnel. The chances of surviving a large heart attack depend on timely and appropriate treatment.

Problems identified by researchers have been seen around the world, but they have been exacerbated in low- and middle-income countries.

Hospitals and clinics at these locations struggled to treat the gold standard with drugs instead of intervention procedures such as stenting an occluded artery.

As a result, the mortality rate of cardiovascular patients in hospitals in low- and middle-income countries has increased, and more people in the UK are dying from cardiovascular disease at home.

The study, which involves an international team of physicians and data scientists led by the University of Leeds, provides the first global assessment of how cardiovascular services dealt with during pandemics.

the study, “Collateral Damage to COVID-19 for Cardiovascular Services-Meta-Analysis“It was published in the European Heart Journal today (Tuesday, May 31st).

In the review, the research team examined the impact of COVID-19 on cardiovascular services from 48 countries on six continents and analyzed data from 189 separate research papers covering the two years from December 2019. did.

Heart disease is the largest murderer in most countries-and analysis shows that among pandemic people around the world, people did not receive the heart care they should have received.

It has an impact.

The longer you wait for treatment for a heart attack, the greater the damage to your heart muscle, causing complications that can lead to fatal or chronic health problems. The health system needs to be strengthened to help and treat people whose heart condition is inevitably worsened due to a pandemic. The dissertation provides that proof. “

Dr. Ramesh Nadaraja, a clinical researcher at the British Heart Foundation at the University of Leeds and the lead author of the paper.

Previous systematic reviews of the effects of COVID-19 on cardiovascular services provided an “incomplete overview,” the researchers said. To address this, they conducted a comprehensive survey of cardiac services in different regions, including hospitalization, heart disease management, diagnostic procedures, outpatient consultation, and mortality. They combined data from multiple studies to show the value of the number of cases seen in hospitals and clinics compared to the expected number of cases in the absence of a pandemic.

Data from low- and middle-income countries are sparse, and researchers say their findings underestimate the true extent of the impact of the COVID-19 disruption on heart services in low- and middle-income countries. believe.

Dr. Samira Asma, Assistant Director of Data, Analysis, and Impact Providing for the World Health Organization (WHO) and one of the authors of the paper, said: And it will be important to continue to study the effects of this turmoil across all continents.

“Analysis reveals that the burden of COVID-19 is declining biased towards low- and middle-income countries, widening the unequal gap in the health outcomes of heart treatment between high-income and low- and middle-income countries. It is believed that 80% of the world’s population lives. This underscores the need for universal health insurance and access to quality care.

Earlier this month, WHO released estimates of pandemic-related excess mortality for COVID-19. This includes people who lack access to the prevention and treatment of cardiovascular disease due to their overwhelming health system.

Between 2020 and 2021, WHO calculated that there were 14.9 million excess deaths worldwide.

“I have heart health problems”-Researchers

As written in the research paper, the authors warn that interruptions in cardiovascular services will leave a legacy that requires immediate action on the part of health care managers.

Researchers said, “Secondary cardiovascular disorders due to failed diagnosis or delayed treatment will continue to occur unless mitigation strategies are implemented promptly, especially with postponement of intervention procedures for structural heart disease. The risk of adverse consequences for patients remains high. “

Professor Chris Gale of the University of Leeds, a consultant cardiologist at the NHS Trust at the University of Leeds and the lead author of the paper, said: Not yet.

“There is no doubt that death and illness that would not have happened otherwise will continue. Urgent action is needed to address the burden of cardiovascular disease left as a result of the pandemic.”

Professor Deepak L. Bart, Executive Director of the Interventional Cardiovascular Program at Brigham and Women’s Hospital, Professor of Medicine at Harvard Medical School, and lead author of the dissertation, said: It is stated in. It is and will continue to harm cardiovascular health worldwide. “

Headline survey results

Researchers used percentages to compare services because the survey statistics were matched differently.

hospitalization

Hospitalization-Around the world, 22% fewer people are experiencing a serious heart attack (STEMI heart attack) in which one of the arteries servicing the heart is completely occluded. There was a 34% reduction in people hospitalized for a less severe form of heart attack, with partially obstructed arteries (NSTEMI heart attack). The decrease in the number of patients was not due to a decrease in heart attacks, but to a decrease in the number of people going to the hospital for treatment.

The decline in hospital attendance was seen worldwide, but was greater in low- and middle-income countries.

Delayed treatment

It took an average of 69 minutes longer from the onset of symptoms to treatment for a serious heart attack.

Management of heart attack

The gold standard treatment for many heart attack patients is to insert a stent into an occluded artery. In many low- and middle-income countries, these procedures performed have dropped sharply. Only 73% of patients had a major heart attack and 69% of patients had a less severe heart attack. .. Instead, there was a shift to treat patients with thrombus-destroying drugs.

Heart surgery

Globally, heart surgery has decreased by 34%.

Intervention procedure

Compared to the non-COVID-19 period, more than half (51%) of electronically implanted devices such as pacemakers used to control abnormal cardiac rhythms were fitted.

Death from heart disease

Globally, among patients hospitalized after suffering a major heart attack or heart failure, the number of people dying from any cause has increased by 17%. This was caused by an increase in the mortality rate of cardiovascular patients in low and middle income countries.

Early studies of the pandemic in the UK revealed a “death replacement” effect in which more people are dying from acute coronary events at home-at 31% instead of the expected 24%. It is running. In long-term care facilities, that figure was 16% vs. 14%.